At least it’s still Monday this week! That’s an improvement. Do I need to set a goal to get my action planning post up by Monday morning? Or maybe move goal setting day to Tuesday…

So, how have y’all been this week? How are those goals working out? Is there more that we can do to help each other with out goals? Ideas?

It’s been a pretty good week at Chez Zaz. Going to rehab has really helped my exercise goal. I still need to work on being more active on the days that I don’t go to rehab. That’s my focus this week – it can be hard to pry myself off my chair when no one is expecting me to make funny faces on the recumbent bike. Good news there, I can make the pedals go all the way around now. I noticed when I was walking my laps that my heel is close to touching the floor. It’d be nice if I could get it all the way and I guess we will see. There may be a water aerobics class in Berryville. I’ll be looking into that when I’m further along in rehab. That’d be great to work out without stressing my joints too much.

My eating goals have been pretty good this week. I had one day that I fell off the rails late at night and I don’t know what was different about that night. Still, it is an improvement and I am letting it be in the past. The next time I feel those temptations when I’m tired and in pain, I will try diverting myself. If I feel like I can’t stay in bed, maybe I’ll sign onto Runescape for a while and kill some monsters.

My blood sugars are a little higher with the med changes. I’m not overly happy, though they are still in the “acceptable” range. I have tweaked the insulin up a little and want to see how that feels a couple days before talking to Dr. G&P.

This is the information the program social worker brought us at our last support group. She doesn’t cite sources and I’ve read at least one study that said that the amount of serotonin released in response to carbohydrates wasn’t enough to cause cravings. Still, it’s interesting and has that “feels right” aspect to it. Or perhaps it just justifies my cravings.

Carbohydrates

• produce serotonin – a neurotransmitter produced in the brain, produces feelings of calm and sedate
• common foods: bread, rice cereals, pastas, potatoes, alcohol, plus fruit, sugars, candy
• carbohydrates include: sugars, starches, fiber
• sugar substitutes will not produce serotonin, so eating them will not give you the brain change that makes you feel better

Low serotonin affects mood, can cause the body to crave carbohydrates, in particular sugar, which temporarily increases serotonin and improves mood. Low serotonin can also result in fat cravings, increased appetite, and reduced satiety.

Sugar and fat, in particular coupled with the smell or taste of food, can stimulate dopaminergic activities or the “reward center” of the brain, producing enjoyment and good feelings. The reward center is associated with most addictive behaviors.

Protein

• Produces dopamine – a neurotransmitter produced int he brain, produces a state of feeling alert and focused

Dopamine is also produced through compulsive gambling, compulsive eating, compulsive shopping and internet addiction. It can be part of a state of relaxation that makes the person escape and feel better. Dopamine affects the “reward center” of the brain.

Fat

• produces endorphins – a neurotransmitter produced int he brain, results in a decrease in both physical and psychological pain
• people who have a lot of physical pain often crave fatty foods
• a history for depression, anxiety or unresolved distress may result in cravings for fatty foods

We’ll just pretend it’s Monday, right. If I were really evil I would back-date this to yesterday morning. What? You didn’t see it?

Time to review last week’s goals and set new ones for this week. How are you doing? What do you want to change?

I think it’s maybe time to review our goals in general. Are we making progress or running into roadblocks? If there are roadblocks – what can we do to find a way around them? Do we need to reconsider what the actual goal is?

As for me, my exercise goal improved greatly by the addition of rehab. As I suspected, it is really helpful for me to have someone actually expecting me to show up. I am going three days per week and trying to do something – anything on at least three other days. That may have been a little high in expectations but I’m keeping it another week. I’m giving myself credit for minimal effort on off days but I’m going to be expecting more of myself soon. It’s important to keep moving and I’ve made some progress despite my reluctance to exercise in general. I walked into the doctor’s office today for the first time for my three-month checkup. I have a nifty new pink walker that everyone admired greatly. It gives me options and I like options. I’m adding “go to the library” to my weekly goals as well. It’s an activity and I should be able to navigate our tiny library with the walker. The chair would have been truly annoying.

My eating goals also improved this week. I’m continuing to keep the same goals as I am making progress. Slow, but progress all the same. I am mostly serving myself smaller portions as stopping when I’m full is still hard for me. I do feel full faster and I’m snacking less. My worst time is 2:00 AM if I’m not sleeping and in a lot of pain. I don’t know quite what to do about that. It turns out – according to the program social worker – that pain is related to certain food cravings. I need to bring the information in from the car and also try to find some sources. So far, simple searching is not finding me what I need to convince me this is true. At any rate, maybe I should eat vegetables at 2:00 AM? That just doesn’t sound nearly as satisfying as a mini bagel, does it?

(reposted from zazamataz.com)

Anyone mind if I go back retroactively and say my goal is to get my A1c under 6.0 this year? I’m pretty sure that was my goal at my last visit with Dr. Great and Powerful but I just didn’t say it out loud.

I really like Dr. Great and Powerful Endo – even if I named him after the Wizard of Oz. I can’t remember that I ever said here why I did that so I’ll tell you now. I was feeling pretty much desperate when I asked for the referral. My blood sugars sucked, I felt out of control, my vision was blurred (and eye stuff scares the hell out of me) and it felt like nothing I did made any difference. Although I knew that much of my diabetes care (or lack thereof) lay squarely on my shoulders, I felt like I was making the trek along the yellow brick road to beg a favor from the great and powerful wizard. He didn’t disappoint.

Dr. G&P has never been judgmental or critical. He has been unfailingly supportive and encouraging. He has been understanding and listened to me and helped me even when I felt nothing I did made things any better. When I chose to do the lap-band, he was right there in my corner rooting me on. And today he says he knows how much work I have done, that the surgery won’t give these results without the work. I guess I really needed to hear that.

He’s really a very sweet man, as well, even though he calls me ma’am. He was tickled pink when he came in the exam room and must have told me half a dozen times how happy I was going to be with my numbers as he went through the myriad of questions and poking and prodding he always does. “I don’t usually look before coming in so I don’t bias myself,” he told me. “But I just couldn’t wait.”

So it’s diabetes celebration time at Chez Zaz. My A1c has dropped from a personal high of 8.4 last August to 5.7 – which Dr. G&P says is the same as a normal person without diabetes. Yes, I know there are those who advocate for even lower numbers which I just don’t see as humanly possible but I’ll bask in my glory for a while, thank you.

Meds have been greatly reduced and he’s cutting them further. I may never be off certain medications but I’ll take significantly reduced any day. I’ve cut the glucophage from 1000mg twice daily to 500mg 2x daily. Glyburide has been reduced from 10mg twice daily to 5mg once daily. Levemir has dropped from 40 units at night to 10 units. And I’ve been able to quit Zestril (a blood pressure medication) altogether.

I have a lot of work to go – but visible, concrete progress is damn good. And how often does your doctor grin like a little boy waiting for you to open your birthday present?

It’s that time again, time to review last week’s goals and set new goals for this week. How’d you do?

In writing your action plan, be sure it includes

what you are going to do,
how much you are going to do,
when you are going to do it, and
how many days a week you are going to do it.

I read Zen Habits daily (through an RSS feed like I read most blogs) but every now and then, a post reaches through the computer screen and pinches me on the arm. Hard.

I think, as people with diabetes, we are constantly having to adapt to big events that challenge our nice routines and best laid plans. How do you get back on track? That’s got to be one of the hardest things we do. We all fall down once in a while but how do you pick yourself up, dust yourself off, and start all over again?

I’m lifting this right from the post but I highly recommend checking out the whole blog, his e-books and reading on a regular basis. You may not agree with everything – but there is a tremendous amount to think about in every post.

How to Beat the Major Disruptions

So how did I do it? How does anyone beat these disruptions and get back on track? A few things I’ve found to be useful:

1. Expect the disruptions and accept them as part of life. I’m not saying you should expect death or the loss of a job or other tragic things to happen at any minute, but do know that there will always be disruptions to your routine. Consider them bumps along the road, a part of any journey, and something that you just need to deal with and then get back on track. If you allow these bumps to stop you every time, you’ll never get to the destination. But if you know, from the outset, that there are going to be bumps, and you know that it’s simply part of the journey and that you have to overcome them, you’ll get there eventually.

2. Always remember your motivation, and get excited. Why did you have the routine in the first place? It must have been something important to you for you to have taken the effort to make it a part of your life. If you were exercising, you must have enjoyed it and had a pretty important goal or reason to exercise. If you were saving money, there must be a strong reason to do so. Always keep your eye on that goal, remember why you were doing it, and get yourself passionate about the goal again. If you get excited enough about it, you’ll go back. It’s when you don’t really feel like doing it that you have a hard time re-starting.

3. Find a partner or a coach or a class. This is just one of the best motivation tips for any goal, but it’s especially useful when you’re trying to get back on track after a disruption. Having a partner, for workouts or any other goal, is a great motivation to get started. It helps that I have my sister to run with, because when we make a date to meet in the early morning hours, I don’t want to miss that date and leave her alone outside while the sun has barely started its first cup of coffee. With business projects, it helps that I have a partner, or I might never get started again when I get sidetracked. A coach or a class are just as good motivators, though personally I’ve found a partner to be more convenient.

4. Start small. Yes, you’ve heard this from me so many times it might as well be a mantra. But it’s good advice for trying to get back into the swing of things. Don’t expect to pick back up exactly where you left off, whether that’s with exercise or diet or work or anything else. For example, if you were running 30 miles a week, you might start out with just 10-15 miles a week — run 3-4 miles, three times a week. Just to start out with. It makes it easier to start out, and it’s something you can adjust to easier. Once you’ve adjusted to this lighter schedule, increase gradually.

5. Allow yourself a break without reproach. When I moved to a new home last week, I knew I’d have to take a break from workouts and work. It wasn’t a planned break, but once I realized how busy I would be, and how tired my body would be from all the lifting and moving, I knew I’d have to take an unplanned vacation. And I told myself, “This is a good thing. My body needed a break from training anyway, and my mind needed a break from work.” And so I took the break, knowing it was good, not feeling (too) guilty, and knowing that I’d get right back into it as soon as the break was over.

6. If all fails, start the habit again, the right way. If you’re just having a tough time restarting, you might need to start back from the beginning, with the basics: focus on just one habit at a time, for 30 days, making it public, giving yourself rewards, finding a trigger, being as consistent as possible. All of these are the effective habit-change principles I talk about in my book, The Power of Less. I highly recommend you read the book if you need help forming habits, and sign up for The Power of Less 30-day Challenge forum.

It’s Monday again and time to review last week’s goals and set this week’s goals!

In writing your action plan, be sure it includes

what you are going to do,
how much you are going to do,
when you are going to do it, and
how many days a week you are going to do it.

One of my favorite blogs is The Happiness Project. While I don’t agree with everything Gretchen has to say, she always provides me with food for thought.

In this post last month, she writes about keeping your New Year’s Resolution. She has some really good tips and let’s face it, they apply to all of our goal setting.

(paraphrasing)

1. Be specific. That’s what we’re talking about in our action plans – be as specific as possible. I still find that challenging. I’m not a scheduler by nature. So, I tend to think this is a “know thyself” area. Be as specific as you can be, leave room to make it work for you.

2. Write it down. Writing it down makes a big difference to me. We’ve been using an action plan from Stanford University. It doesn’t work for you? Make whatever changes you need to make it meaningful for you! (plus, since only TDW is playing along these days, I’m not going to keep reposting the form. Click on “Action Planning” in the blog categories list to see all the posts about this topic.)

3. Review your goal constantly. Does it “slip your mind”? I suspect I actively try to forget I’ve got an exercise goal. The more it’s right there in front of you, reminding you to follow through, the better. Just do it in a positive way. I’m in total disagreement with those who do things like stick a picture of a pig on the fridge. That’s not a positive goal, that’s constant negative self messages. Still, I guess, whatever works for you!

4. Hold yourself accountable. Tell other people about your goal, join or form a like-minded group, sit down at the end of each day or week or month and tally how well you did on your goal. That’s part of why I’m writing about it here – making it public. I have everyone who reads these blogs both cheering for me and holding me accountable to do what I’ve said I’m going to do.

5. Think big. Maybe you need a big change. Just because your goal isn’t something that can be accomplished in a week doesn’t mean you don’t include it on your list. Allow yourself to imagine really big changes – then break them into smaller steps for actual action planning.

6. Think small. “Don’t fall into the trap of thinking that only radical change can make a difference.” Remember the power of the gradual. When you do one small thing every day it grows to be a big thing.

7. Ask for help. Why do so many of us refuse to ask for help? It’s okay not to be able to do everything on your own! Plus, don’t forget that helping others often helps you. So, look for ways to help other people achieve their goals as well.

8. Consider making only positive resolutions. Are you someone who sets “improvement” goals and then feels terrible because you not only have you failed at forcing yourself to do something really hard – but you needed improving in the first place? Consider reframing your goal to view the change more positively. Instead of setting a goal to lose weight, maybe you need a goal to learn healthy eating strategies or gourmet low-fat cooking. Losing weight is hard and has a lot of negative feelings attached to it. Learning about healthy eating or learning new cooking techniques sounds like it might be fun!

9. Consider giving up a resolution. “If you keep making and breaking a resolution, consider whether you should relinquish it entirely. Put your energy toward changes that are both realistic and helpful.” You know, the definition of insanity is doing the same thing over and over and expecting different results. Maybe it’s time to let go of a goal. Maybe you need to remake it into a more realistic goal or change the goal entirely. I could keep setting the goal to go to the gym every day for the rest of my life and I can pretty much guarantee I am never going to achieve it. So, find the plan that is right for you.

10. Set a deadline. Vague goals are hard to meet. If you have a goal of getting your taxes done on time, you know you have until April 15th in the US. What if there was no deadline? Would you ever finish your taxes?

12. Don’t give up if something interferes with your deadline. Be flexible. If you have some health issues getting in the way of your exercise goal – don’t beat yourself up about it. Readjust your goal and get back to work. If you see that interruption as a failure, you are less likely to want to go back to work on the goal.

13. “The perfect is the enemy of the good.” -Voltaire Remember, we are talking about building on success, not setting yourself up for failure. Another quote I like in this area is, “Striving for excellence motivates you; striving for perfection is demoralizing.” -Harriet Braiker

So what other strategies would you add that help you keep your goals or resolutions?

I thought I’d let y’all know that I’ve been experimenting with Dreamfields Pasta. I was a little skeptical – most of the lower carb pasta I’ve tried has tasted a lot like cardboard.

It turns out that Dreamfields macaroni is really good. I don’t taste any difference at all. Calories and protein are roughly the same as regular pasta, even carbohydrates are listed as the same. Dreamfields has slightly more fiber than regular pasta.

What’s different is that most of Dreamfields carbs are “protected” carbs and not digestible. From some of the reading I’ve done, it seems that these protected carbs are not effective for everyone. But for me – my postprandial blood sugar after eating low fat macaroni and cheese made with Dreamfields was 95.

Yeah. That does it for me. I love pasta and I pay for it every time I eat it. 95 after eating pasta? Bizarre!

At any rate, so far I’m recommending Dreamfields. I wish it was available in stores around here but so far I have to mail order it which is not all that cost effective. I may have to buy some in bulk but I think it’ll be worth it.

Has anyone else tried it? Had similar or different results or opinions?

Oh, and no, Dreamfields has not paid me for my opinion. But hey, I’m open to that idea… they could pay me in free pasta – that’d be a great idea as far as I’m concerned.

Here’s the Action Plan – please feel free to copy it or to write your goal out a little more informally now that we’re used to the different parts of the plan.

In writing your action plan, be sure it includes

what you are going to do,
how much you are going to do,
when you are going to do it, and
how many days a week you are going to do it.

For example: This week, I will walk (what) around the block (how much) before lunch (when) three times (how many).

This week I will __________________________________ (what)

______________________________________________ (how much)

______________________________________________ (when)

______________________________________________ (how many)

How confident are you? (0% not confident at all – 100% totally confident without reservation)

Daily/Weekly review: comments, problem identification and solving.